Burden of stroke attributable to high ambient temperature from 1990 to 2019: A global analysis.

AIMS: To determine the global and regional burden of stroke due to high temperature and the spatiotemporal trends in 204 countries and territories from 1990 to 2019. METHODS: Based on Global Burden of Disease Study 2019, deaths, disability-adjusted life years (DALYs), and age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) for stroke attributable to high temperature (i.e. a daily mean temperature warmer than the theoretical minimum-risk exposure level (TMREL)) were calculated in global, geographical location, and country and analyzed by age, sex, subtypes, and socio-demographic index (SDI) from 1990 to 2019. The trends in ASMR and ASDR from 1990 to 2019 were estimated by linear regression model. The regression coefficients (ß) referred to a mean change of per year for ASMR or ASDR attributable to high temperature. RESULTS: The global burden of stroke attributable to high temperature had an increase trend from 1990 to 2019 (ß = 0.005, 95% uncertainty interval (UI) = 0.003-0.007 for ASMR and ß = 0.104, 95% UI = 0.066-0.142 for ASDR, respectively). Globally, in 2019, an estimated 0.048 million deaths and 1.01 million DALYs of stroke were attributable to high temperature, and the global ASMR and ASDR of stroke attributable to high temperature were 0.60 (95% UI = 0.07-1.30) and 13.31 (1.40-28.97) per 100,000 population, respectively. The largest burden occurred in Western Sub-Saharan Africa, followed by South Asia, Southeast Asia, and North Africa and the Middle East. ASMR and ASDR increased with age and were higher in males and for intracerebral hemorrhage, and were the highest in the low SDI regions. In 2019, the region with the largest percentage increase in ASMR and ASDR attributable to high temperature was Eastern Sub-Saharan Africa from 1990 to 2019. CONCLUSIONS: Stroke burden due to high temperature has been increasing, and a higher burden was observed in people aged 65-75 years, males, and countries with a low SDI. Stroke burden attributable to high temperature constitutes a major global public health concern in the context of global warming.

Spatiotemporal trends of cardiovascular disease burden attributable to ambient PM2.5 from 1990 to 2019: A global burden of disease study.

There is little known about the global burden of CVD attributable to ambient PM2.5 (referred to as CVD burden hereinafter) and its secular trend across different regions and countries. We aimed to evaluate the spatiotemporal trends in CVD burden at the global, regional and national levels from 1990 to 2019. Data on CVD burden including mortality and disability adjusted of life years (DALYs) from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019. Cases, the age-standardized rate of mortality (ASMR) and DALYs (ASDR) were estimated by age, sex and sociodemographic index (SDI). Estimated annual percentage change (EAPC) was calculated to evaluate the temporal changing in ASDR and ASMR from 1990 to 2019. In 2019, 2.48 million deaths and 60.91 million DALYs of CVD were attributed to ambient PM2.5 globally. Most CVD burden occurred in males, elderly and the middle SDI region. At national level, Uzbekistan, Egypt, and Iraq had the highest ASMR and ASDR. Despite remarkable increase in number of DALYs and deaths of CVD worldwide from 1990 to 2019, we observed nonsignificant change in ASMR (EAPC: 0.06, 95 % CI: -0.01, 0.13) and slight increment in ASDR (EAPC: 0.30, 95 % CI: 0.23, 0.37). The EAPCs of ASMR and ASDR were negatively associated with SDI in 2019, while the low-middle SDI region exhibited the fastest growth of ASMR and ASDR with EAPCs of 3.25 (95 % CI: 3.14, 3.37) and 3.36 (95 % CI: 3.22, 3.49), respectively. In conclusion, the global CVD burden attributable to ambient PM2.5 has largely increased over the past three decades. The population growth, aging and SDI contributed to the heterogeneity of spatial and temporal distribution. Enforcing policy to improving air quality is required to halt the growing burden of PM2.5 on health.

Using social media data to assess the impact of COVID-19 on mental health in China.

BACKGROUND: The outbreak and rapid spread of coronavirus disease 2019 (COVID-19) not only caused an adverse impact on physical health, but also brought about mental health problems among the public. METHODS: To assess the causal impact of COVID-19 on psychological changes in China, we constructed a city-level panel data set based on the expressed sentiment in the contents of 13 million geotagged tweets on Sina Weibo, the Chinese largest microblog platform. RESULTS: Applying a difference-in-differences approach, we found a significant deterioration in mental health status after the occurrence of COVID-19. We also observed that this psychological effect faded out over time during our study period and was more pronounced among women, teenagers and older adults. The mental health impact was more likely to be observed in cities with low levels of initial mental health status, economic development, medical resources and social security. CONCLUSIONS: Our findings may assist in the understanding of mental health impact of COVID-19 and yield useful insights into how to make effective psychological interventions in this kind of sudden public health event.

The disease burden of childhood asthma in China: a systematic review and meta-analysis.

BACKGROUND: In China, childhood asthma prevalence showed a remarkable increase in the past decades. An updated epidemiological assessment of childhood asthma in China with a focus on prevalence and time trends is required. METHODS: We systematically searched three main Chinese databases and one English database to identify epidemiological studies of the prevalence of childhood asthma in China. Asthma cases were defined according to one of the five sets of Chinese diagnostic criteria which were established by the Children Respiratory Disease Group. We estimated age- and sex-specific prevalence of asthma using a multilevel mixed-effects logistic regression. We presented the time trends of asthma prevalence between 1990 and 2020 by age, sex and setting (urban vs rural), and also estimated the number of children affected by asthma in 2010. RESULTS: In 1990, the prevalence of asthma ranged from 0.13% (95% confidence interval (CI) = 0.10-0.20) in rural girls aged 14 years to 1.34% (95% CI = 1.11-1.67) in urban boys aged five years. In 2010, the overall prevalence of asthma in Chinese children aged 0-14 years was 2.12% (95% CI = 1.83-2.51), corresponding to 5.16 million children living with asthma. Children aged 5-9 years were with the highest prevalence estimate of 2.65% (95% CI = 2.31-3.12) and those aged 10-14 years were with the lowest (1.48%, 95% CI = 1.26-1.78). In 2020, it is expected that this disparity will continue, with the prevalence of asthma being at the lowest level among rural girls aged 14 years (1.11%, 95% CI = 0.82-1.54) and at the highest level among urban boys aged four years (10.27%, 95% CI = 8.61-12.18). Over the 30 years (1990-2020), the prevalence of asthma in children aged 0-14 years has increased in both sexes and settings, which was consistently the lowest in rural girls and the highest in urban boys. CONCLUSIONS: This study shows that childhood asthma has been increasingly prevalent in China. Asthma is more frequent in boys and in rural areas. The detailed and systematic estimates of asthma prevalence in this study constitute the best currently available basis for policymaking, planning, and allocation of health and welfare resources related to the burden of childhood asthma in China.

A Comparison of the Nutritional Risk Screening 2002 Tool With the Subjective Global Assessment Tool to Detect Nutritional Status in Chinese Patients Undergoing Surgery With Gastrointestinal Cancer.

The objectives of this study were to describe the nutritional status of Chinese patients with gastrointestinal cancer undergoing surgery and to compare the ease of use, diversity, and concordance of the Nutritional Risk Screening 2002 with the Subjective Global Assessment in the same patients. A total of 280 gastrointestinal cancer patients admitted for elective surgery were evaluated by the Nutritional Risk Screening 2002 (NRS 2002) and Subjective Global Assessment (SGA) tools within 48 hours of admission from April to October 2012. Related opinions about ease of using the tools were obtained from 10 nurses. The prevalence of patients at nutritional risk with the SGA and NRS 2002 was 33.9% and 53.2% on admission. In the total group, ≤70 age group, and >70 age group, respectively, consistency was observed in 214 (76.4%), 175 (91.1%), and 39 (44.3%); and kappa values were 0.54 (p < .001), 0.81 (p < .001), and 0.085 (p = .096). McNemar paired chi-square test showed a significant difference between the NRS 2002 and SGA in the total group and >70 age group (p < .001); however, no difference was observed in the ≤70 age group (p = .14). Nurses reported ease of use of the NRS 2002 as a "very easy" or "easy" to complete (3-5 minutes) and the SGA as an "easy" or "fair" tool to complete (5-10 minutes). The diversity and concordance between the SGA and NRS 2002 were varied in different age groups. The NRS 2002 is more suitable in nursing practice than the SGA to identify the nutritional status of patients with gastrointestinal cancer undergoing surgery, but it appeared to detect more patients at nutritional risk in the >70 age group.